Epidemiol Health.
2023;45(1):e2023068. 10.4178/epih.e2023068.
Unequal burdens of COVID-19 infection: a nationwide cohort study of COVID-19-related health inequalities in Korea
- Affiliations
-
- 1Department of Sociology, Yonsei University, Seoul, Korea
- 2Department of Preventive and Occupational & Environmental Medicine, Pusan National University Medical College, Yangsan, Korea
- 3Office of Public Healthcare Service, Pusan National University Yangsan Hospital, Yangsan, Korea
- 4Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
- 5Center for Public Health Data Analytics, National Medical Center, Seoul, Korea
- KMID: 2548037
- DOI: http://doi.org/10.4178/epih.e2023068
Abstract
OBJECTIVES
While the Korean government’s response to the coronavirus disease 2019 (COVID-19) pandemic is considered effective given the relatively low mortality rate, issues of inequality have been insufficiently addressed. This study explored COVID-19-related health inequalities in Korea.
METHODS
Age standardization for various health inequality indices was derived using data from the Korean National Health Insurance Service, the Korea Disease Control and Prevention Agency, and the Microdata Integrated Service of Statistics Korea. The slope index of inequality (SII) and relative index of inequality (RII) were calculated for socioeconomic variables, while absolute difference (AD) and relative difference (RD) were used for gender and disability inequalities.
RESULTS
We observed a number of COVID-19-related health outcome inequalities. Gender inequality was particularly noticeable in infection rates, with the rate of women 1.16 times higher than that of men. In contrast, socioeconomic inequality was evident in vaccination rates, with a 4.5-fold (SII, -4.519; 95% confidence interval, -7.403 to -1.634) difference between the highest and lowest household income groups. Regarding clinical progression post-infection, consistent findings indicated higher risk for men (RD for hospitalization, 0.90; severe cases, 0.54; and fatality, 0.65), individuals with disabilities (RD for hospitalization, 2.27; severe cases, 2.29; and fatality, 2.37), and those from lower socioeconomic groups (SII for hospitalization, 1.778; severe cases, 0.089; and fatality, 0.451).
CONCLUSIONS
While the infection risk was nearly ubiquitous, not everyone faced the same level of risk post-infection. To prevent further health inequalities, it is crucial to develop a thoughtful policy acknowledging individual health conditions and resources.
